Provider Demographics
NPI:1124025556
Name:LEWIS, MARGARET SUSAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:SUSAN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3947 DUNN RD # 304
Mailing Address - Street 2:
Mailing Address - City:EASTOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28312-8533
Mailing Address - Country:US
Mailing Address - Phone:910-483-6277
Mailing Address - Fax:910-483-6369
Practice Address - Street 1:3551 DUNN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:EASTOVER
Practice Address - State:NC
Practice Address - Zip Code:28312-8794
Practice Address - Country:US
Practice Address - Phone:910-483-6277
Practice Address - Fax:910-483-6369
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200825363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS69349Medicare UPIN
NC2571179DMedicare ID - Type Unspecified